Health Policy Formulation and Agenda Setting

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Table of Contents

The Nature of Problems That Drive Policy Formulation
The Involvement of Interest Groups
The Role of Presidents or Governors
Reference

The Nature of Problems That Drive Policy Formulation

Problems, political circumstances, and potential solutions are key variables in policy agenda-setting. The problems that drive policy formulation stem from two sources: determinants of health and the external environment. Determinants of health include peoples living and working physical environments, social factors, individuals biology and behaviors, and the quality, timing, and type of healthcare they have access to (Meacham, 2020). The external environment comprises elements such as individuals and organizations preferences and biological, cultural, economic, social, legal, and other variables (Meacham, 2020). Although these factors affect policymaking, not all of them find a place in the agenda.

Only important and urgent problems appear on the policy agenda, leading to legislation. According to Meacham (2020), problems are the most likely to incite policymakers action if they have high salience and low conflict. It means that the public should be highly concerned about these problems at present or in the future, and there should be few disagreements among interest groups regarding these problems and possible solutions.

There are several ways for problems to become part of the agenda. First, it may happen when trends in particular health variables reach unacceptable levels. For example, increasing uninsured individuals and Medicare cost escalation were such trends, and policymakers had to address these problems through the Affordable Care Act (Meacham, 2020). Second, problems are discovered because of their widespread applicability or a significant impact on a directly affected small, powerful group. Examples of such problems are the high cost of prescription drugs and high tuition fees in medical education (Meacham, 2020). Third, some problems appear on the agenda because of their close relation to other problems on the list. Finally, problems may emerge through several of the described paths, meaning that they can both concern a large number of people and be linked to other important problems.

The Involvement of Interest Groups

Interest groups have a significant influence on the political circumstances affecting agenda setting. They usually present a unified opinion on a particular issue of their concern, and it is easier for policymakers to evaluate and respond to such a unified opinion rather than to diverse views of individuals. One more advantage of interest groups is that their position is highly predictable based on whose interests it protects. For example, an interest group of healthcare providers aims to lower operating costs, increase prices, and raise the demand for their services, while an interest group of consumers intends to decrease prices and facilitate access to care.

There are several specific ways for interest groups to influence agenda setting: lobbying, electioneering, litigating, and shaping public opinion. Lobbying refers to communicating with policymakers to influence their decisions and make them more favorable toward the lobbyists employers interests (Meacham, 2020). Lobbyists affect policymakers decisions by providing them with information, assisting in developing and implementing political strategy, helping them in reelection efforts, giving them innovative ideas, and befriending those they intend to influence (Meacham, 2020). Electioneering means assisting candidates for political office using resources at the interest groups disposal. The purpose of this activity is to achieve the election of the candidate who is sympathetic to the groups interests because this candidate will be more easily influenced in the future.

Litigation is another tactic used by interest groups, which refers to challenging existing policies, encouraging the development of new policies, or altering some aspects of policy execution. Interest groups appeal to the judicial branch when there are legal or constitutional questions related to the impact that the actions of the other two branches have on the members of this group (Meacham, 2020). There are two ways of using litigation: amicus curiae briefs and test cases. The former refers to interest groups influencing appellate courts decisions on cases they are not directly involved in, while the latter means initiating or participating in a case concerned with the groups interests to establish a precedent. Finally, shaping public opinion is done through advertisements and various media campaigns. Interest groups use this tactic because the electorates attitudes and views impact policymakers decisions. In using all the described ways of influencing, interest groups use a wide variety of physical, organizational, political, intangible, and motivational resources.

The Role of Presidents or Governors

Chief executives, including presidents and governors, have an important role in setting the health policy agenda at the federal level. In particular, their administration and party usually have a unified perspective on various issues, and they can substantially shape public opinion, successfully competing with powerful interest groups and exerting pressure on legislators. Chief executives can present problems and preferred solutions in speeches, addresses, and press conferences, thus increasing the visibility of these issues and solutions. Candidates for the presidency can also draw public attention to specific issues in their election campaigns; for example, President Bill Clinton emphasized his commitment to health reform in his 1992 campaign (Meacham, 2020). Furthermore, chief executives can appoint special commissions and task forces to place issues on the agenda. They can also influence the policymaking process by making the legislative branch develop legislation and concentrate on issues they prefer, even though other problems need attention. Finally, being at the top of the executive branch, governors and presidents have the power to influence the implementation and modification of policies.

Reference

Meacham, M. R. (2020). Longests health policymaking in the United States (7^th ed.). Health Administration Press.

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Health Policy Formulation and Agenda Setting

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